Wagner, Faith P

Wagner, Faith P is an individual health care provider with primary practice located at 2500 State Rd , La Crosse WI 54601-5098. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wagner, Faith P can be contacted via phone (608) 775-5858.

Contact Information

Primary practice address
2500 State Rd La Crosse WI 54601-5098
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 1778 Wisconsin

Profile Details

NPI number 1841295987
LBN Legal business name Wagner, Faith P
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jun 16th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841295987 NPPES
Wisconsin MEDICAID 43931800

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